More than a quarter of people who die from liver disease in hospital have no previous admission in the year before their death

Posted on: 19th September 2019

New data released today at the largest conference for liver clinicians reveals that around 5,200 people die from liver disease in hospital in England each year. Of these, 30% of those have not had an admission in the year before death. On admission to hospital time is of the essence in saving these seriously ill patients. 1 in 4 of those who die do not survive more than 3 days and 43% do not survive a week.

These are people with advanced liver disease and many of their lives could have been saved if they had been diagnosed earlier in primary or secondary care and had been given advice on risk factors like alcohol and management of their liver disease.

The analysis is being presented at the British Association of Liver Disease annual conference in Glasgow. The data also reveals that these deaths occur in relatively young people. 60% of these patients are under 64 years of age and that one in five are under the age of 50.

Liver disease has increased by 400% since 1970 and it’s the biggest cause of death in those aged between 35-49 years old in the UK.[1]

This new data highlights the urgent need for improvements in early detection of the disease as most patients are being diagnosed too late in an emergency setting.

Professor Matthew Cramp, president at BASL, says: “Many people with liver disease are unaware that they have it because there are usually have no symptoms in the early stages.  Too often the first a patient knows about their liver disease is when they are admitted as an emergency to hospital with life threatening complications. Even with the doctors’ best efforts some patients are so ill that their life cannot be saved.”

“It’s vital that GPs and other healthcare professionals identify those at risk so that more patients are diagnosed at an early stage.”

The research used Office for National Statistics mortality data and Hospital Episode Statistics data supplied by NHS Digital. Other alarming facts highlighted by the research:

  • 1% of the patients who died in hospital had no previous admission in the year
  • 8% had only one previous admission in the year before they died
  • 3% of those who die do not survive more than 3 days in hospital
  • 43% of those who die do not survive more than a week in hospital.
  • 2,230 liver patients die each year in hospital in a week or less from admission, that is 43 patients per week or 6 patients every day.
  • The majority (60%) of those dying from liver disease in hospital are under the age of 64 and 20% are under the age of 50.
  • At least two-thirds of the patients who died with no previous admission in the year before death died from alcohol related liver disease
  • Patients admitted to hospitals with specialist liver services are more likely to be seen by a specialist in liver disease and be admitted to ITU

Professor Matthew Cramp, president at BASL, says: “Despite being young and very sick, many patients die from the disease without ever being seen or cared for by a specialist. Patients with life-threatening liver disease complications need to be recognised quickly when they arrive at hospital and should be seen by a specialist with knowledge of liver disease quickly and treated according to Guidelines.”

This study found that the chance of these patients being seen by a specialist (Gastroenterologist or hepatologist) and being admitted to ITU was higher if they were admitted to a hospital with specialist liver services.

Matthew Cramp adds: “Smaller hospitals should link with specialist hospitals to consult with experts or transfer patients if appropriate.”

Liver problems develop silently with no obvious symptoms in the early stages yet if caught early, the disease can be reversed through lifestyle changes.  More than 90% of liver disease is due to three main risk factors: obesity, alcohol and viral hepatitis.

Pamela Healy, Chief Executive, British Liver Trust said, “This research highlights the liver disease epidemic we are facing in the UK. While the data presented is based on England only, this is likely to reflect the situation with liver disease in Scotland, Wales and Northern Ireland.”

To coincide with the BASL conference, The British Liver Trust’s Love Your Liver roadshow is at the University of Strathclyde today offering free liver health screening and scanning.

Pamela continues: “Helping people understand how to reduce their risk of liver damage is vital to address the increase in deaths from liver disease. Although the liver is remarkably resilient, if left too late damage is often irreversible. I would urge everyone who is unable to attend the roadshow to take our online screener on our website to see if they are at risk.”

[1] https://britishlivertrust.org.uk/about-us/media-centre/statistics/